The Register's Editorial: Licensing boards must never forget duty to citizens

May 8, 2013

An Iowa City girl gets her teeth checked during a dental screening. / Iowa City Press-Citizen file photo

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The Register’s Editorial

“Cease and desist” letters
should also be public

Russell Berke was advising terminally ill patients in Fairfield not to seek traditional medical treatment and was offering his services to help them. Dennis Meador of the Open Door Baptist Church was examining people, diagnosing medical conditions and recommending treatment in Muscatine. Vivianne Kaberna was providing “cold laser therapy” to help Ankeny clients quit smoking and lose weight. None of these people was a licensed physician, and all were recipients of “cease and desist” orders from the Iowa Board of Medicine stating the obvious: It appears you are violating the law and you better cut it out. The job of a licensing board isn’t only to oversee qualified professionals. It is to help ensure that unqualified and unlicensed people are not working in the state. The medical board places all such orders online for the public to see. The Iowa Dental Board sends similar “cease and desist” letters to unlicensed people. Yet it does not post these letters online for the public to see, even though they are public records. These letters help ensure consumers know the guy down the street providing dental screenings has been told by the state he’s violating the law. They let an entrepreneur know the business he is considering opening may not be allowed. Melanie Johnson, executive director of the Iowa Dental Board, said she would immediately work to get such letters online. To read more editorials and columns about job licensing in Iowa, visit DesMoinesRegister.com/joblicensing.

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It is estimated nearly one-third of American workers must hold a government license or government certification to earn a living. Only six states require more licenses for low- and middle-income occupations than Iowa. The result: More than 30 state boards grant thousands of Iowans permission to work.

These boards are charged with ensuring everyone from barbers and physicians to optometrists and dietitians meet state requirements for training and education. The ultimate goal is protecting the safety of the public. Yet, because most of the boards are comprised largely of industry insiders, there is a danger they may instead end up focused on protecting the workers they are supposed to regulate.

The Iowa Dental Board shows that is exactly what can happen.

Among its responsibilities is pursuing complaints by consumers against dentists, dental hygienists and dental assistants. Though such complaints are not public, if an investigation finds wrongdoing, the board can impose sanctions, including revoking a worker’s license. That information is a public record.

Obviously, it should be easy for Iowans to see such records. Consumers should be able to know if the person providing a health care service has been deemed an “immediate danger to the public” or has violated safety standards. While other licensing boards do an exceptional job of placing this information on their websites indefinitely, the dental board has gone out of its way to block public access to sanctions imposed on those in the dental profession.

This board places disciplinary information online for 12 months — then removes it and requires the public to either pay $24 for an online subscription or make a public records request to view it in person. The Des Moines Register’s editorial board could find no other Iowa licensing board that did anything like this.

So an Iowan can easily find out if his physician was placed on probation 10 years ago for prescribing excessive amounts of controlled substances to patients. Yet that Iowan cannot easily know if 13 months ago, his dentist violated state standards to control infections in patients.

This is unfair to consumers who want to know about the histories of the professionals they are entrusting with their lives.

The Register editorial board stumbled across this practice while working on a series about state licensing boards. Though it illustrates what can happen when licensing boards operate unchecked, the result of our inquiry speaks to the importance of having competent, objective people overseeing the boards.

The dental board’s executive director, Melanie Johnson, is one of those people. She looked into our questions, thanked us for bringing the practice to her attention and said she would immediately work to place online all sanctions imposed on dental professionals for the past 10 years. She said the policy was instituted before she joined the board’s staff.

Now the Iowa Administrative Code must be updated to address the policy as well. It allows the board to charge an annual subscription fee to obtain “electronic files of statements of charges, final orders and consent agreements.” That must be clarified to ensure Iowans are not charged to view records that are readily available online.

Licensing boards exist to protect public health. The dental board’s policy has only served to protect dentists from public accountability. A change in this policy is a step in the right direction.